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Objectives: to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil., Methods: a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors "Nursing Theory" and "Nursing Models" and the uncontrolled descriptors "Theories" and "Middle-Range Theory" were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories., Results: thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity., Conclusions: the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.

Objective: To describe the process of best practices implementation for breastfeeding assistance for preterm and low birth weight infants., Method: Participatory research that used the evidence implementation methodology of the JBI, held at a university hospital in southeastern Brazil, with the participation of a multidisciplinary team and managers., Stages: Situational diagnosis, baseline audit and feedback, protocol development, training, implementation, and monitoring., Results: Seven audit criteria were defined. In the baseline audit, three criteria were met, with eleven barriers to be resolved being listed. The strategies carried out were protocol development and multidisciplinary and intersectoral training. After the training, compliance was achieved with the seven criteria audited in the first follow-up audit and five in the second, emphasizing the increase in compliance after the implementation of the outlined strategies., Conclusion: The project achieved the objective of improving evidence-based practice, and allowed the implementation of the institution's first breastfeeding protocol. However, it shows the need to maintain training for adherence and enculturation of new practices.

Objective: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard., Method: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed., Results: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes., Final Considerations: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

Objectives: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility., Methods: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019., Results: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes., Conclusions: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Objective: describe the process of designing and implementing a care protocol for the first hour of life of premature newborns., Method: a participatory research study using an implementation science framework, the Consolidated Framework for Implementation Research (CFIR) was employed to determine drivers and facilitators of implementation success of the Golden Hour protocol for newborns at a large university hospital in southeastern Brazil. A multi-professional team, including first line providers and managers participated in six stages of quality improvement: situational diagnosis; protocol elaboration; training protocol implementation; barrier and facilitator assessment; and protocol monitoring and review. Qualitative and monitoring data collected across these six stages were analyzed using descriptive statistics and content analysis., Results: the institution's Golden Hour protocol was organized by the multi-professional team based on a collective and dialogical approach. The protocol prioritized the infant's cardiopulmonary stability, as well as prevention of hypothermia, hypoglycemia and infection. After four months of implementation, the care team was evaluated the protocol as a good quality intervention, necessary for the service, low-cost and not very complex. One suggested improvement recommended was to carry out refresher training to address staff turnover., Conclusion: implementation of the Golden Hour protocol introduced an appropriate and feasible neonatal care quality improvement process, which requires periodic refresher training to ensure greater adherence and better neonatal results.

Objective: To describe and interpret a woman's perception of her body image during the breastfeeding process., Method: Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding., Results: Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes., Conclusion: The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.

Objective: To develop a registration standard with diagnoses, outcomes and nursing interventions for an Emergency Care Unit., Method: This is applied research of technological development developed in three steps: elaboration of diagnoses/outcomes and interventions statements following the International Classification for Nursing Practice; assessment of diagnosis/outcome relevance; organization of diagnosis/outcome and interventions statements according to health needs described in TIPESC., Results: A total of 185 diagnoses were prepared, of which 124 (67%) were constant in the classification, and 61 had no correspondence. Of the 185 diagnoses, 143 (77%) were rated as relevant by 32 experienced emergency room nurses, and 495 nursing interventions were correlated to diagnoses/outcomes., Conclusion: It was possible to build a record standard for the Emergency Care Unit following standardized terminology, containing diagnostic statements/outcomes and relevant interventions for nursing practice assessed by nurses with practice in emergency.

Objective: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process., Methods: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout., Results: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges., Final Considerations: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

Objective: To describe the process of elaboration and implementation of a protocol for the prevention and management of pediatric falls., Method: This was an actionresearch developed at a public hospital in Southeast Brazil with 10 members of the multidisciplinary team from the pediatrics, maternity, neonatal intensive care sectors, and the patient safety center. To elaborate the protocol, literature review, three meetings with the group, and two rounds ofonline correction were carried out. Online training was carried out for all professionals and then the use of the protocol was started at the sectors., Results: A pediatric fall prevention protocol was implemented. Educational materials were developed and the Humpty Dumpty Falls Scale was chosen to assess the risk of falling., Conclusion: The process was conducted in a collective and participatory way. The protocol and the educational materials guide and standardize behavior based on the best evidence and involve users, family members and professionals in the management of the risk of falling.

To identify a clinical judgment of susceptibility referring to the development of glycemic fluctuations in adults with Diabetes Mellitus undergoing treatment. Theoretical study with construct analysis. The exploration of the phenomena of glycemic variations provided clues for the description of the blood glucose pattern construct and the proposal of a new risk Nursing diagnosis as a judgment of susceptibility to the balance of this pattern. The risk factors for "Risk for Imbalanced Blood Glucose Pattern" are cognitive dysfunction; excessive alcohol consumption; excessive daily exercise; inadequate follow through with treatment regimen; increased frequency of self-monitoring of blood glucose; inadequate knowledge of disease process; inadequate management of amount of food; inadequate regularity of meal consumption; obesity; overweight; smoking; underweight. The elaboration of "Risk for Imbalanced Blood Glucose Pattern" Nursing diagnosis contributes to the advancement in the Nursing classifications and to the elaboration of planning actions and specific interventions.

Objective: To develop and validate Nursing Diagnoses statements of the International Classification for Nursing Practice (ICNP®) aimed at the care of people with chronic kidney conditions undergoing conservative treatment., Method: This is a methodological research structured in sequenced construction stages, cross-mapping, content validation by the Delphi Technique by specialist nurses, and categorization of Nursing Diagnoses., Results: Forty-two specialist nurses participated in the first round and 34 in the second. A total of 179 Nursing Diagnoses statements were prepared, categorized according to Roy's adaptation model, of which 160 were validated for content, with Content Validity Index ≥ 0.80., Conclusion: The Diagnoses developed and validated show the modes of adaptation to health of people with chronic kidney conditions undergoing conservative treatment, influenced by biological, psychological, social, and cultural needs, with the Physiological Mode being the most prevalent.

Objectives: to describe the contribution of pregnant women to the construction and evaluation of educational technology., Methods: a participatory study developed in three stages, which occurred between March 2018 and June 2019 for identifying the content, construction, and evaluation of the comic. Non-directive interviews were conducted in educational groups with 34 pregnant women. After the comic was built by a team, including a designer, an instrument was applied to 41 pregnant women to evaluate the items Objectives, Organization, Writing style, Appearance, and Motivation., Results: the comic contains 40 pages of contents, illustrations, and quizzes (word search, cross-puzzle, seven mistakes, etc). The pregnant women evaluated it as easy to understand, self-explanatory, aesthetically attractive, and capable of motivating good care practices during pregnancy, obtaining a minimum agreement of 92.1%., Final Considerations: the innovation of the educational technology consisted of incorporating the voices of pregnant women in prenatal care, with the potential to stimulate reflections and the learning process of this target audience.

Objectives: to develop an ICNP® terminology subset to care for people with tuberculosis., Methods: a methodological research that followed the following steps: identification and validation of empirical indicators of altered needs relevant to people with tuberculosis based on literature; cross-mapping of the empirical indicators of altered needs identified with ICNP® 2017 terms; construction of nursing diagnoses/outcomes and interventions; assessment of relevance of nursing diagnoses /outcomes and interventions and ICNP® terminology subset structuring., Results: an ICNP® terminology subset was developed to care for people with tuberculosis with 51 diagnoses/outcomes and 264 nursing interventions, assessed by nurses from Primary Health Care and structured according to Wanda Horta's Theory of Basic Human Needs., Final Considerations: the subset is a technological instrument through which it is possible to identify the elements of nursing practice from the affected human needs.

Objective: to describe the process of developing a software for emergency bed management., Methods: a participatory research based on User-Centered Design in four stages: 1) definition of requirements and structure elaboration; 2) generation of alternatives and prototyping; 3) tests; 4) implementation. Seminars were held with health professionals between May 21, 2018 and May 31, 2019 for the preparation and assessment of software content., Results: the software CuidarTech KRONOS was developed for emergency bed management using the kanban methodology., Final Considerations: this software will assist professionals' and managers' decision-making providing more reliable data to enable the improvement of work processes and the quality of patient care. Developing a bed management software is innovative in the health field, and no articles were found describing this methodology.

Objective: To assess the prevalence of postpartum depression symptoms among puerperal women and their association with violence., Methods: This was a cross-sectional study with puerperal women cared for at a public maternity hospital in Cariacica, ES, Brazil, in 2017. A questionnaire prepared by the authors and validated instruments were used. Pearson's chi-square test was performed in the analysis and association was expressed in prevalence ratios (PR) and 95% confidence intervals (95%CI)., Results: Postpartum depression symptom prevalence was 36.7% (95%CI 31.6;42.0). Total family income was inversely associated with this prevalence (p<0.05). Mothers who were single (PR=1.75 - 95%CI 1.17;2.64), wished to abort (PR=1.96 - 95%CI 1.50;2.56), drank alcohol during pregnancy (PR=1.37 - 95%CI 1.00;1.86), experienced intimate partner violence in their lifetime (PR=1.94 - 95%CI 1.38;2.73), and during pregnancy (PR=1.41 - 95%CI 1.07;1.85), had higher prevalence of depression symptoms., Conclusion: Postpartum depression symptoms are associated with marital status, wanting to abort, alcohol consumption during pregnancy and intimate partner violence.

Objectives: to describe the construction and validation process for a mobile application for development of the nursing history and diagnosis., Methods: methodological study conducted in 2018 in three stages: content creation, based on the Basic Human Needs categories and nursing diagnoses; content assessment by nine nursing judges, with calculation of the content validity index; and construction of the application, which included definition of the requirements, a conceptual map, implementation and prototyping options, tests and implementation., Results: the application was organized by sections: Grouped Basic Human Needs, Cranial pair tests, Clinical assessment scales and Additional tests. Two section were adjusted according to the judges' suggestions., Final Considerations: it is the first application produced in Brazil based on the Basic Human Need categories, which enables quick access to information, concepts and typical nomenclatures of semiology, recording of clinical data and definition of nursing diagnoses.

Objective: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios., Methods: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil., Results: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic., Final Considerations: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

Objective: To describe the process of construction and assessment of the content of a Virtual Learning Object on preventing bloodstream infections associated with infusion therapy., Method: Methodological study carried out in three stages: elaborating the technical, scientific content; assessing theoretical content; and constructing the Virtual Learning Object., Results: We produced the theoretical content of the Virtual Learning Object. Such content obtained an 85% agreement in assessment, which was adequate. The final product comprised 39 content screens, which integrate the main recommendations and contain images, hypertexts, videos, case studies, and quiz, through an exclusive platform., Final Considerations: This study made it possible to portray the method for constructing and assessing the content of a Virtual Learning Object, enabling am easy application to health professionals, aiming at guiding them to quality care.

Purpose: To analyze the concept of "Death anxiety" (00147) and to propose modifications in the components of this diagnosis in Taxonomy II of NANDA-I., Methods: A conceptual analysis was developed based on the eight steps proposed by Walker and Avant., Findings: Twenty-six articles were included from a search in four databases. Three defining attributes, nine antecedents, and two consequent ones were identified from concept analysis., Conclusions: Conceptual analysis made possible the clarification of this diagnosis and the proposition of modifications in its components, which could provide a diagnostic accuracy., Implications for Nursing Practice: Clarification of the diagnosis will allow the accurate identification of this phenomenon in clinical practice and, consequently, more appropriate nursing interventions., Objetivo: Analisar o conceito de "Ansiedade relacionada à morte" (00147) e propor modificações nos componentes deste diagnóstico na Taxonomia II da NANDA-I. MÉTODOS: Uma análise conceitual foi desenvolvida com base nos oito passos propostos por Walker e Avant., Resultados: Vinte e seis artigos foram incluídos a partir de uma busca em quatro base de dados. Três atributos definidores, nove antecedentes e dois consequentes foram identificados a partir da análise deste conceito. CONCLUSÕES: A análise conceitual possibilitou a clarificação deste diagnóstico e a proposição de modificações em seus componentes, o que poderá proporcionar uma acurácia diagnóstica. IMPLICAÇÕES PARA A ENFERMAGEM: A clarificação do diagnóstico possibilitará a identificação precisa deste fenômeno na prática clínica e, consequentemente, intervenções de enfermagem mais adequadas., (© 2019 NANDA International, Inc.)

Objective: to describe risk management implementation in the safety of patients with mental disorders through action research., Method: an action research carried out with a multidisciplinary team from a reference hospital in mental health in Southeast Brazil., Results: three strategies considered as managerial technologies for the mentally ill patient were developed: risk management diagram for patient safety; patient safety protocols; and textual proposal of software for internal management of incident notifications., Final Considerations: this action research allowed a collective discussion by the whole multidisciplinary team, enabling strategy drafting for risk management implementation and improvement of care quality in the safety of patients with mental disorders at the study site.

Objective: To describe and interpret the experience of breastfeeding among women who underwent mammoplasty surgery prior to motherhood., Method: A descriptive, qualitative study developed with women attended at a Human Milk Bank between 2014 and 2015. Data analysis was based on the content analysis method and supported by the Interactive Theory of Breastfeeding., Results: 13 women participated in the study. Four categories emerged: 1) Success (or lack thereof) in Exclusive Breastfeeding: influence of maternal and child biological conditions; 2) Maternal feelings: perception about breastfeeding; 3) Decision making on the continuity of breastfeeding or the use of formula; 4) The role of health professionals in protecting, promoting and supporting breastfeeding: Information (or lack thereof) on the implications of the surgery., Conclusion: Unfavorable biological conditions of the women who underwent mammoplasty generated unsuccessful experiences in exclusive breastfeeding and limited their decision-making, despite their desire to breastfeed.

Objective: To describe the development of a terminology subset of the International Classification for Nursing Practice for care of women and children in process of breastfeeding., Method: Methodological study developed in six stages according to the guidelines recommended by the International Council of Nurses., Results: Seventy-four nursing diagnoses/outcomes and 213 nursing interventions were performed and classified according to the theoretical model Interactive Theory of Breastfeeding., Conclusion: The subset is expected to safely and systematically steer nurses that work in this area, promoting the implementation of the nursing process and quality of care, focusing on women, children and families that are experiencing the breastfeeding process.

Objective: To produce a reflection on the ability of the V diagram to integrate theoretical, conceptual, and methodological knowledge obtained from complex, non-explicitly identifiable systems, models, and theories., Methods: Reflection study with an analytical characteristic., Results: The V Diagram is presented as an instrument that can ensure an integrated analysis between theoretical and conceptual knowledge (worldview and philosophy, theories, principles, constructs, and concepts), and the analysis or production of methodological knowledge (data records, transformations, knowledge assertions, and value assertions). Examples are related to the Unified Health System (SUS), and care in Psychosocial Care Centers for Alcohol and Drugs., Conclusions: V diagram is an instrument capable of producing an integrated analysis of the knowledge contained in productions linked to complex and non-explicitly identifiable models and theories as a theoretical model, theory or framework applying deductive and inductive procedures.

Objective: To investigate the Nursing diagnostic accuracy measures and to propose a model to use defining characteristics in order to judge the nursing diagnosis of ineffective breastfeeding., Method: Cross-sectional study with a sample of 73 binomials mom-child hospitalized in a maternity ward of an University Hospital, from July to August of 2014., Results: The diagnostic predominance rate was 58.9%. The characteristics that best meet the needs of logistic regression model were: discontinuance of breast sucking; infant's inability of seizing the areola-nipple region correctly; infant's crying one hour after breastfeeding and inappropriate milk supply perceived., Conclusion: Breastfeeding process is dynamic; diagnostic judgement may suffer some changes according to the time data are collected; the defining characteristics are the best predictors if associated with models and rules of use.

Objective: to elaborate and validate animation on the care of premature newborn infants at home., Method: Methodological study in three stages: integrative review on home care; animation design based on Roper, Logan and Tierney's Model named "Activities of Living" (ALs), and validation of content and appearance by neonatology specialists. The steps to develop the animation were: creation of storyboard; definition of objects; specification of keyframes; and frame generation among key frameworks., Results: Of the 53 articles selected in the review, care was extracted and grouped into the twelve activities of living. Three storyboards were created to embrace all care and validated by 22 experts. Most of the care had matches above 80%., Conclusion: The validation of the storyboards made it possible to glimpse the changes in scenes and dialogues in a clearer and more detailed way. Animation is an innovative educational technology to support teaching and learning of parents and family.

Objective: To describe a breastfeeding theory based on King's Conceptual System., Method: Theoretical study that used analysis of concept, assertion synthesis, and derivation of theory for the creation of a new theory., Results: King's system components were associated with elements of the breastfeeding process and a middle-range theory was created, which describes, explains, predicts, and prescribes breastfeeding by analyzing factors that precede and affect it, as well as their consequences on the breastfeeding process., Conclusion: The Breastfeeding Interactive Model is abstract enough to be applied in different social, cultural, political, and economic contexts, because it conceptualizes breastfeeding in systemic, dynamic, and procedural aspects. Based on a conceptual model of nursing, it contributes to the scientific construction of the subject; however it can also potentially be applied by other professionals involved in breastfeeding assistance.

Aims and Objectives: To present a systematic review of papers published on the relationship between violence against women and cervical cancer screening., Background: Violence against women is a serious public health problem. This phenomenon can have negative effects on victims' health and affect the frequency at which they receive cervical cancer screening., Design: A systematic literature review., Methods: This study was carried out in October 2015 with searches of the Lilacs, PubMed and Web of Science databases using the following keywords: violence, domestic violence, battered women, spouse abuse, Papanicolaou test, vaginal smears, early detection of cancer and cervix uteri., Results: Eight papers published between 2002-2013 were included in this review, most of which were cross-sectional studies. Three studies found no association between victimisation and receiving Pap testing, and five studies reported an association. These contradictory results were due to higher or lower examination frequencies among the women who had experienced violence., Conclusion: The results of this study indicate that the association between violence against women and cervical cancer screening remains inconclusive, and they demonstrate the need for more detailed studies to help clarify this relationship., Relevance to Clinical Practice: Professionals who aid women should be knowledgeable regarding the perception and detection of violence so that they can interrupt the cycle of aggression, which has harmful impacts on victims' health., (© 2016 John Wiley & Sons Ltd.)

Cytogenetic studies in fish of the Rineloricaria genus have already shown a high variation in diploid number (2n). Along with fusion/fission events for 2n alteration, inversions contribute to the diversification of chromosome formulae within this group. The present study assessed different populations/species of the Rineloricaria aiming to describe the karyotype organization of its members and understand the mechanisms that lead to the variation of chromosome numbers. Cytogenetic data showed distinct karyotype organization among Rineloricaria populations/species studied, ranging in diploid number from 46 to 64 chromosomes, syntopic species and two karyomorphs in Rineloricaria pentamaculata. Using ribosomal DNAs (rDNAs) and TTAGGGn probes by fluorescence in situ hybridization in species with low diploid numbers, we detected sites of 18S rDNA, 5S rDNA, and TTAGGGn in centromeric regions of metacentric chromosomes, which participated in chromosome rearrangements like centric fusions. In species with high 2n, centric fissions probably occurred in karyotypic diversification. In this study, we assessed the telomeric instability, chromosomal breaks, and rearrangements due to interstitial telomeric site vestiges detection, in addition to the probable role of rDNAs in chromosome fusions in karyotypic diversification of this group.

Objective To evaluate the quality of the Prenatal Information System of the city of Vitoria - ES. Methods This is a cross-sectional study with an analysis of the Prenatal Information System Data (SISPRENATAL) from a municipality in the Southeast Region of Brazil. The quality of the system was evaluated according to the accessibility criteria, methodological clarity, timeliness and completeness defined by the Economic Commission for Latin America and the Caribbean (ECLAC). Completeness was evaluated according to the criteria of incompleteness proposed by Romero and Cunha, and assigned scores in degrees of evaluation for: excellent, good, fair, bad and very bad. Results Most of the results presented scores of bad and very bad quality. Fields with excellent or good quality for incompleteness are related to the mandatory items. Conclusion Professionals need to be aware of the proper registration of the care provided to pregnant women.

Objective: this study sought to assess the quality of the Family Health Strategy (FHS) and investigated the association between primary care attributes (PCAs) and the sociodemographic characteristics of users., Method: a total of 215 female FHS users were interviewed for this descriptive and cross-sectional study. The Primary Care Assessment Tool (PCATool), Adult Edition was used, and the results were analyzed using Fisher's exact tests, Pearson's chi-square tests and logistic regressions., Results: the lowest average score corresponded to the dimension "accessibility" (1.80), and the highest score corresponded to "access" (8.76). The results corresponding to the attributes "longitudinality", "coordination", "comprehensiveness", and "orientation" were not significant. No association was found between the participants' sociodemographic characteristics and the essential, derivative, and general attributes (p>0.05)., Conclusion: several attributes must be improved across all the investigated services from the perspective of female FHS users.

Objective: to undergo a content analysis of a metacognitive strategy of indirect assessment in the pre-encounter with the client., Method: methodological study. Agreement and inter-rater reliability index for the criteria: relevance, adequacy, clarity, conciseness and accuracy of a technology to the nursing diagnosis reasoning for novices through an electronic form. The sample consisted of 13 raters. Data were analyzed using descriptive statistics., Results: high agreement and inter-rater reliability for 85 items related to data collection stage and the strategy description. Only fi ve items did not reach the validation criteria and must be rewritten., Conclusion: indirect assessment of the pre-encounter is relevant to the diagnostic reasoning process, being possible to develop competencies and diagnostic skills in the novice through strategies, proposals on innovative technology in the form of a diagram.

The study aimed to analyze the defining characteristics of the Dysfunctional Ventilatory Weaning Response as an indicator of the accuracy of ventilatory weaning. Observational study of 38 events of ventilatory weaning in adult patients admitted to intensive care. For the defining characteristics, it was calculated: sensitivity, specificity, positive and negative predictive values, accuracy or efficiency, likelihood ratio positive and negative, and diagnostic odds ratio. It was also considered the median number of defining characteristics in the event of success and failure. It was considered accurate: agitation, deterioration in arterial blood gases from baseline parameters, moderate use of accessory muscles of respiration, increased respiratory rate from baseline parameters and respiratory rate increases significantly with respect to baseline parameters. There was statistical difference in the median number of defining characteristics observed. It was concluded that the defining characteristic and the number of them would influence the success of the weaning decision.

Objective: To asses the performance of the Ten Steps to Successful Breastfeeding in an university hospital., Methods: Descriptive and quantitative research, in which 103 people were interviewed in the outpatient prenatal clinic, in the maternity-ward and in the Neonatal Intensive Care Unit of a university hospital in Vitória, Southeast Brazil. The "Institutional Self-Evaluation Questionnaire" of the Baby Friendly Hospital Initiative was applied. Using this tool, the outcome was measured by the concordance index (CI) proposed by the World Health Organization and by the United Nations Children's Fund., Results: Although the hospital does not have a policy that addresses promotion, protection and support for breastfeeding, 93.3% of the mothers had contact with their babies immediately after birth (step 4), 83.3% of the professionals guided mothers how to breastfeed (step 5), 86.6% of the neonates did not receive any food or drink other than breast milk (step 6), 100% of babies were housed together with their mothers (step 7), 83.3% of the women were encouraged for breastfeeding on demand (step 8) and 100% of the infants did not use bottles or pacifiers (step 9)., Conclusions: 60% of the steps were completed by the hospital. The greatest difficulty was to inform pregnant women about the importance and the management of breastfeeding (step 3). Therefore, visits to pregnant women are recommended, in order to prepare them for breastfeeding and to explain about the infants' healthy feeding habits.

OBJECTIVE To assess scientific evidence about the effects of maternal nicotine on infant by an integrative review. DATA SOURCES Studies published in Portuguese, English and Spanish, from 1990 to 2009, with abstracts available in the Latin American Health Sciences Literature (Lilacs) and Medical Literature Analysis and Retrieval System On-Line (Medline) databases. The descriptors were: "breastfeeding", "lactation" and "smoking". DATA SYNTHESIS The main identified effects of nicotine on infants were: changes in sleep and wakefulness patterns; reduction of iodine supply; hystopathological damage on liver and lung; intracellular oxidative damage; reduction of pancreatic ß cells; and decreased glucose tolerance. CONCLUSIONS It is recommended to inform mothers about harmful chemicals contained in cigarettes that can be secreted into breast milk. They should be strongly encouraged to stop smoking during lactation.

The objective was to analyze the risk factors associated with neonatal mortality in the city of Serra, ES. We studied non-concurrent cohort, using the technique of Linkage that relate the 32.275 live births with 273 neonatal deaths occurred in the period from 2001 to 2005, using data from SINASC and SIM. After adjustments in the logistic regression, factors associated with mortality were: uneducated mothers, maternal age <15 years and > 35 years old, born in a public hospital, no prenatal consultation, birth weight.

This experimental study aimed to evaluate the effect of relaxation techniques on anxiety levels, and the relation between anxiety and the concentration of Immunoglobulin A. The study was carried out in a maternity hospital in a city of the State of Espírito Santo, Brazil. The sample was composed of 60 puerperae. The information on the variables: age, education, marital status, type of childbirth, and parity were collected with a specific form; the trait and state of anxiety were based on the State Trait Anxiety Inventory (STAI/IDATE); and the level of salivary IgA was obtained through immunoturbidimetry. The application of the Mann-Whitney, Wilcoxon, and Pearson's correlation statistical tests showed a significant reduction in the levels of the state of anxiety in the experimental group (p = 0.01); there was no correlation between the trait and state variables of anxiety and the salivary IgA level; both groups (experimental and control) showed trait and state of medium-intensity anxiety.

OBJECTIVE: This study is the result of an inquiry into the grandmother's role in the decision as well as the duration of her daughter's choice to breast-feed. METHOD: This project uses a phenomenological theoretical background which leads one to understand breast-feeding based on the view of the grandmother. Thus, this project analyzes the discourse of 10 women by using the following guiding questions: Howdid you feed your children when they were born? What did you think about your daughter's choice to breast-feed? Why do you think your daughter decided to breast-feed? RESULTS: The analysis of the discourses as a whole reveals that for these women breast-feeding is something intrinsical to a mother's role as well as an experience transferred from mothers to daughters. This project also reveals that breast-feeding is a family tradition which can be influenced by advice and support. CONCLUSION: From this perspective, a new focus is revealed by giving advice, supporting and encouraging breast-feeding.

Cryptococcocal meningoencephalitis is always considered secondary to initial lung infection. Because of the unquestionable evidence of haematogenious spread from the lungs, few publications have reported about other possible primary sites of infection or other routes to the central nervous system. This study was designed to investigate the infiltrative pattern of C. neoformans in immunocompromised mice by treatment with dexamethasone. The infection was performed by nasal instillation (30 mice) or injection into the retro-orbital space (12 mice). From the group infected intranasally, 3 mice presented diffuse invasive fungal colonisation of the mucosa and submucosa. The histologic findings showed infiltrative growth along the periosteum, sometimes surrounded nervous endings of submucosa, invasion along the olfactory nerve and simultaneous meningeal involvement in 2 mice on the 6th and 8th day of infection. All mice infected into the retro-ocular space developed lesions containing numerous cryptococci in the local of the inoculum. Out of the main lesion we observed preferential growth along the perineural spaces with adherence to the perineurium, perivascular spaces and sometimes along aponeurosis. Simultaneous invasion of trigeminal ganglio and trigeminal branches was observed in 4 mice. These morphologic patterns suggest the hypothesis of direct infiltrative invasion of the central nervous system.